Provider Demographics
NPI:1871982504
Name:ALLEN, JO DEE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JO
Middle Name:DEE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:JO
Other - Middle Name:DEE
Other - Last Name:ISMAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6405 S MOGEN AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5705
Mailing Address - Country:US
Mailing Address - Phone:605-670-0664
Mailing Address - Fax:
Practice Address - Street 1:401 W 2ND ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-2313
Practice Address - Country:US
Practice Address - Phone:605-336-6252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1604174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist